Suicide prevention action plan 2018 - 2020: review

Overview

Background

Every Life Matters, Scotland's Suicide Prevention Action Plan (SPAP) 2018 - 2021 (Scottish Government, 2018), sets out the Scottish Government's cross-sectoral plan to further reduce the suicide rate by 20% by 2022 (from the 2017 baseline). The Plan contains 10 'Actions' and is being led by the National Suicide Prevention Leadership Group (NSPLG).

Commissioned by the National Suicide Prevention Leadership Group, the following is a rapid review of progress over the period September 2018 to October 2020. This is based on responses to a brief survey completed by the delivery leads for each of the Actions and the Lived Experience Panel co-ordinator. The aim of the Review is to draw out the lessons from the implementation process to date, taking into account the ongoing implications of COVID-19. The findings are intended to contribute to the continuing work of the NSPLG and Scottish Government Suicide Prevention and Self Harm Policy Team. They also offer learning to inform the development and implementation of any future suicide prevention strategy and action plan.

Key learning points

• There is clear progress toward implementation of the SPAP, with evidence of momentum building. Actions are, however, at different stages of delivery and the COVID-19 pandemic has also necessitated pauses to work and some re-prioritisation of effort.
• There is evidence of extensive engagement, collaboration and partnership working across the different Actions. This includes engagement with the wider workforce beyond people working in mental health and with the general public, as well as people with lived experience. There is also evidence of substantial partnership and collaboration with local suicide prevention leads, statutory and third sector providers, and other agencies with parallel or overlapping interests.
• The review reveals the important role of the Lived Experience Panel in contributing to the planning and development of the Actions, providing training, as well as bringing their own voices to the public awareness campaign. There is scope for learning from the operation and impacts of the Panel. In the short term, consideration may need to be given to mechanisms for sustaining the degree of involvement and commitment of members of the panel over time.
• The extensiveness of engagement suggests that the process of delivery may itself contribute to the social movement that the United to Prevent Suicide public awareness campaign is seeking to generate.
• The review also reveals the need to take into account the long lead-in time before delivery of Actions.
• Early consideration of the infrastructure, e.g. early appointment of a programme manager and delivery leads, clear processes for sign off of project plans, including proposals for recruiting supporting staff and governance processes, might have helped to further speed up delivery.
• In relation to several of the Actions, progress was hampered by the absence of high quality evidence of effectiveness on which to base proposals or recommendations.
• An outcomes framework underpinning the SPAP might have helped to clarify: the focus and purpose of each Action; the short-term outcomes each was intended to achieve; and how each Action was expected to contribute to the goal of a 20% reduction in suicide rates. It might have also helped to identify measures for monitoring and evaluating the extent to which each Action was progressing toward these outcomes.

Conclusions

The review suggests that, while momentum is increasing, the pace of progress has perhaps been slower than anticipated. COVID-19 has meant some Actions were postponed or re-prioritised. Other external factors may have also delayed progress. But the review does suggest that some of the barriers relate to implementation processes. This underlines the need for operational, as well as strategic, leadership, with sufficient resources (time, personnel, funding) to support delivery.

The review does, however, also draw attention to the extensive stakeholder engagement that has been undertaken, and the key role of those with lived experience in shaping delivery of the Plan.

There is limited available evidence concerning whether and how the different Actions, collectively or individually, may contribute to the ultimate goal of a reduction in suicidal behaviour. As the SPAP moves forward, there may be value in investing in further support for evaluation and monitoring. The Review highlights the importance of ensuring that any subsequent suicide prevention strategy is evidence informed, outcome-focused, and builds in monitoring and evaluation from the start.